Inis Jane Bardella, MD, FAAFP Associate Dean Faculty Development & Global Health Initiatives

1. Educating and Mentoring Medical Students and Residents in Global Health: Short and Medium Term International Experiences Inis Jane Bardella, MD, FAAFP Associate Dean Faculty Development & Global Health Initiatives Professor Department of Family & Preventive Medicine Chicago Medical School, Rosalind Franklin University North Chicago, IL USA

2. Session Objectives • Discuss the need and opportunity for sustainable models of medical education globally that honor God. • Explore models and strategies for medical student and resident GH education & mentoring that maximize in-country partner benefit, minimize harm and disruption, and facilitate sustainability. • Discuss the benefits, challenges and outcomes of short and medium term international experiences for medical students and residents. • Apply these concepts for education & mentoring of future medical education leaders globally.

3. Rationale • Commanded • Go ye therefore, and make disciples of all nations, baptizing them into the name of the Father and of the Son and of the Holy Spirit: teaching them to observe all things whatsoever I commanded you: and lo, I am with you always, even unto the end of the world. Matthew 28:19-20 ASV

4. Rationale • Opportunity • More than 25% of US medical students participate in international experiences during medical school. • Most of this interest continues into residency. • Students and residents in low-income and middle income countries desire/demand enhanced education and training. • Concern • Wide array of experiences and opportunities • Harm and disruption from non-evidence-based, non-biblical-value-based approaches

5. Rationale • Jesus’ effective model • Spiritual teaching • Professional development • Modeling • Interactive discussion • Experiential learning • Entrustable professional activities (EPAs)

6. Rationale • Responsibility • And to whomsoever much is given, of him shall much be required; and to whom they commit much, of him will they ask the more. Luke 22:48b ASV • Who better to teach the next generation? • Value human life • Believe we are accountable to God • What better method than living your life as a Christian health professional?

7. Needs and Opportunities

8. Needs and Opportunities • High level of student, resident & faculty interest in global health in high-income countries • Desire and need for clinical, research, education development in low- and middle-income countries • Student & resident call to Christian faith-based domestic & international missions

9. Needs and Opportunities • Global need and desire for health equity – improved morbidity and mortality in all countries • Faculty have a high level of influence on students, patients and colleagues. • Thus, desire and need for …

10. Needs and Opportunities • … • Educationally appropriate, worthwhile experiences • Reasonable safety, accountability in experiences • Discipleship and mentoring of students, residents, colleagues • Development of low- and middle-income partners • Sustained, collaborative, equitable partnerships focused on the needs and priorities of the partner • Minimizing harm and disruption for the partner

11. Models and Strategies • Caveats • Think long-term outcomes. • Spiritual • Professional • Clinical • Inspire and communicate vision. • Modeling speaks louder than words. • Your life is being watched. • Students, residents, colleagues desire meaningful relationships.

12. Curriculum Models: Literature Search • Independent elective courses • Didactic • Experiential • Clinical • Project, non-clinical • Research • Selective options for required courses • Required clerkship at an international site

13. Curriculum Models: Literature Search • Formal (required) curriculum • Integrated into courses • Specific global health courses • Tracks, programs, concentrations • Dedicated program with requirements • Recognized at graduation • Fellowships • Post residency • May offer additional degree

14. Models and Strategies • Be the US partner. • Medical school or residency US partner • Judeo-Christian values and principles to guide the partnership, even if is a secular institution • US “local” global health site for a medical school or residency • Required experiences • Elective experiences • Teach, model Judeo-Christian principles, values, even if the institution(s) is/are secular.

15. Models and Strategies • Be the low-income partner. • Institutional partnership • Education • Research • Clinical care • Engage faculty • Foundation • Core • Engage students, residents • Clinical • Research • Development project

16. Models and Strategies • Be an advisor. • Career • Specialty • Take the student/resident with you • Be a mentor. • Global health program • Global health projects and research • Student/resident Christian group • Take the student/resident with you

17. Models and Strategies • Be clinical faculty. • Consistent involvement • Permits credit for experience • Substantiates your teaching role • Provides opportunity for broader engagement • Admissions • Curriculum • Affiliations • Research • Development

18. Models and Strategies • Maximize in-country partner benefit, minimize harm and disruption, and facilitate sustainability. • Long-term partnerships with shared vision and goals • Clear expectations, goals, objectives • Consistent involvement and engagement • Pre-travel preparation • Post-travel debriefing

19. Benefits for Students and Residents • Refinement, clarification of call, vision, direction • Can better prepare for the future • Spiritual, academic, professional development • More fruit • More effective • Fulfillment of curricular requirements • Exploration of new directions, possibilities

20. Challenges for Students and Residents • Expense • Insurance • Medical liability • Travel • State Department travel warnings • For residents, may not have salary and benefits during experiences outside the US. • Appropriate, required supervision • Coordination of time with school/program schedule.

21. Outcomes for Students and Residents • Clarification of call and life direction • Maturity of faith • Enhanced knowledge, skills, attitudes for professional Christian practice • Gaining a mentor • Initiate opportunities for long term engagement

22. Application • How can you engage with students and residents? • What are the challenges to consider and address? • What are the potential benefits for you/your practice? • What additional models, approaches should be considered?

23. Summary • Seek out methods to engage students and residents in your international and local missions endeavors. • Be a mentor. • Be clinical faculty. • Embrace opportunities to disciple and mentor the next generation.

24. Content Resources • GHEC/CUGH modules • http://www.cugh.org/resources • PRiME • http://www.prime-international.org.uk/home.htm • Millions Saved: Proven Successes in Global Health (Ruth Levine) • Understanding Global Health (William Markle, Melanie Fisher, Jr., Ray Smego) • Burden of Disease • http://www.thelancet.com/themed/global-burden-of-disease • http://www.who.int/topics/global_burden_of_disease/en/

25. Content Resources • Social Determinants of Health (Michael Marmot, Richard G. Wilkinson) • USAID Global Health eLearning • http://www.globalhealthlearning.org/ • Unite for Sight, Global Health eLearning • http://www.uniteforsight.org/global-health-university/courses • Kaiser Family Foundation, Global Health Policy • http://kff.org/slides/global-health-policy/ • Harvard School of Public Health: Teaching cases (pdf) and Case Studies (video recordings of lectures) • http://www.globalhealthdelivery.org/case-studies/ • John Hopkins School of Public Health Open Courseware • http://ocw.jhsph.edu/

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31. MurakozeChaneShume Falemindarit Merci Beaucoup Asante SanaMucho gracias inisbardella@gmail.com